Obesity, metabolic syndrome, and inflammation: An update for anaesthetists caring for patients with obesity

被引:10
作者
Eley, Victoria A. [1 ,2 ]
Thuzar, Moe [2 ,3 ,4 ]
Navarro, Severine [5 ,6 ]
Dodd, Benjamin R. [2 ,7 ]
van Zundert, Andre A. [1 ,2 ]
机构
[1] Royal Brisbane & Womens Hosp, Dept Anaesthesia & Perioperat Med, Butterfield St, Herston, Qld 4006, Australia
[2] Univ Queensland, Fac Med, St Lucia, Qld 4067, Australia
[3] Princess Alexandra Hosp, Dept Endocrinol & Diabet, Ipswich Rd, Woolloongabba, Qld 4102, Australia
[4] Univ Queensland, Endocrine Hypertens Res Ctr, Diamantina Inst, Ipswich Rd, Woolloongabba, Qld 4102, Australia
[5] QIMR Berghofer Med Res Inst, Dept Immunol, Herston Rd, Herston, Qld 4006, Australia
[6] Queensland Univ Technol, Fac Hlth, Woolworths Ctr Childhood Nutr Res, Sch Exercise & Nutr Sci, Kelvin Grove, Qld 4059, Australia
[7] Royal Brisbane & Womens Hosp, Dept Upper GI & Bariatr Surg, Butterfield St, Herston, Qld 4006, Australia
关键词
Anaesthesia; Inflammation; Metabolic syndrome; Obesity; Renin-angiotensin; Surgical procedures; LOW-CALORIE DIET; BODY-MASS-INDEX; GUT MICROBIOTA COMPOSITION; RENIN-ANGIOTENSIN SYSTEM; ACTIVATED-RECEPTOR-GAMMA; PREOPERATIVE WEIGHT-LOSS; TOTAL JOINT ARTHROPLASTY; WHITE ADIPOSE-TISSUE; BARIATRIC SURGERY; INSULIN-RESISTANCE;
D O I
10.1016/j.accpm.2021.100947
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Our understanding of chronic inflammation in obesity is evolving. Suggested mechanisms include hypoxia of adipose tissue and a subsequent increase in circulating cytokines. It is now known that adipose tissue, far from being an inert tissue, produces and secretes multiple peptides that influence inflammation and metabolism, including substrates of the renin-angiotensin-aldosterone system (RAAS). RAAS blocking antihypertensive medication and cholesterol-lowering agents are now being evaluated for their metabolic and inflammation-modulating effects. Surgery also has pro-inflammatory effects, which may be exacerbated in patients with obesity. This narrative review will summarise the recent literature surrounding obesity, metabolic syndrome, inflammation, and interplay with the RAAS, with evidence-based recommendations for the optimisation of patients with obesity, prior to surgery and anaesthesia. (C) 2021 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.
引用
收藏
页数:10
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